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by Alan Mozes

Health Highlights: March 1, 2015

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Nearly 1 Billion Teens, Young Adults at Risk for Hearing Loss: WHO
At least 1 billion teens and young adults are at risk for hearing loss from too much exposure to loud music, both on their smartphones and at concerts and sporting events, according to the World Health Organization.
So, the agency has recommended that listening to unsafe levels of music on personal audio listening devices be limited to one hour a day.
WHO also recommended that teens take listening breaks and lower the volume on their smartphones.
In its report, released Friday, WHO said volumes above 85 decibels for eight hours or 100 decibels for 15 minutes are unsafe.
In middle- and high-income countries, almost half of all those aged 12 to 35 listen to unsafe levels of music on their personal audio listening devices or smartphones, the WHO review found.
And almost 40 percent are also exposed to loud music at nightclubs, bars and sporting events, WHO added.
"As they go about their daily lives doing what they enjoy, more and more young people are placing themselves at risk of hearing loss," Dr. Etienne Krug, WHO Director for the Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, said in a WHO news release. "They should be aware that once you lose your hearing, it won't come back. Taking simple preventive actions will allow people to continue to enjoy themselves without putting their hearing at risk."
Actor Leonard Nimoy Dies of COPD at Age 83
Leonard Nimoy, best known for his role as Mr. Spock on "Star Trek," died Friday morning at age 83.
The actor was hospitalized earlier this week and died at his home in Los Angeles. His wife, Susan Bay Nimoy, confirmed his death and said the cause was end-stage chronic obstructive pulmonary disease (COPD), The New York Times reported.
Last year, Nimoy announced he had the disease and said it was caused by his years of smoking, which he gave up three decades ago.
Nimoy was cast as Mr. Spock -- the Vulcan first officer of the starship Enterprise -- in the original "Star Trek" series, which first aired in the mid-1960s but was canceled after three seasons. Nimoy continued to play Spock in subsequent movies and TV series, with his last appearance in the 2013 movie "Star Trek Into Darkness."
U.S. Military Ends Ebola Mission in Liberia
The United States' military officially ended its five-month Ebola aid mission in Liberia on Thursday.
At one point, there were 2,800 U.S. military personnel in Liberia, but the number gradually fell as the epidemic began to subside. The Pentagon said nearly all troops will be gone from Liberia by the end of April, Agence France-Presse reported.
"The importance of the progress we see today means more than just the reduction in the number of new or suspected cases of Ebola," mission commander Major General Gary Volesky said. "This progress is also about Liberians being able to get back to a normal way of life."
About 100 U.S. troops will remain in the region to boost the "disease preparedness and surveillance capacity" of local governments, the Pentagon said.
Liberia was hardest hit by the Ebola outbreak in West Africa, accounting for 4,037 of the approximately 9,600 deaths. The outbreak began in Guinea in December 2013 and at its height, Liberia and Sierra Leone had between 300 and 550 confirmed, suspected and probable Ebola cases a week, AFP reported.
As of last Sunday, there have been fewer than 400 new cases in all three countries in the previous three weeks, according to the World Health Organization.
U.S. Abstinence Programs in Africa Ineffective Against HIV/AIDS: Study
U.S. efforts to promote abstinence and fidelity in Africa in order to prevent the spread of HIV have been largely useless, a new study says.
The $1.3 billion spent on the program since 2005 did not measurably change sexual behavior, second-year Stanford Medical School student Nathan Lo said at an AIDS conference in Seattle, The New York Times reported.
Lo's work was overseen by Dr. Eran Bendavid, an assistant professor of medicine at Stanford, who has conducted previous analyses of American global anti-AIDS programs for the Institute of Medicine, part of the National Academy of Sciences.
The findings were applauded by critics of the U.S. policy of promoting abstinence and fidelity as a way to combat HIV/AIDS.
"That was fantastic," said Dr. Gilles van Cutsem, medical coordinator for Doctors Without Borders in South Africa, The Times reported.
Restrict Use of New Meningitis Vaccines: Experts
Two newly-approved meningitis vaccines should be used sparingly, a U.S. expert panel says.
The vaccines should be restricted to vulnerable people during outbreaks and not given routinely to teens and college students, the Advisory Committee on Immunization Practices said Thursday, NBC News reported.
The two vaccines -- Trumenba and Bexsero -- were approved by the Food and Drug Administration to protect against the B strain of meningits. However, insurers usually don't pay for vaccines unless they're recommended by the advisory committee.
The decision is likely to anger parents who lobbied for wider use of the two vaccines, NBC News reported.
by Alan Mozes

Nerve Treatment Via Nose Shows Promise Against Migraines

Therapy reduced pain level by about one-third for up to a month, study found
SUNDAY, March 1, 2015 (HealthDay News) -- A procedure that delivers the anesthetic lidocaine (Xylocaine) directly to nerves in the back of the nasal cavity appears to offer significant relief to migraine sufferers, preliminary research indicates.
Early findings suggest that a single outpatient treatment can reduce migraine pain levels by about 35 percent for up to a month after the procedure, according to this small, ongoing study.
The technique is "a minimally invasive treatment option," said the study's lead author Dr. Kenneth Mandato, a vascular and interventional radiologist at Albany Medical Center in Albany, N.Y. He added that he views the new procedure as "a clear simple alternative" to standard migraine treatments.
"This nasal spray option is safe, convenient and innovative," said Mandato.
In the new study, his team focused on 112 patients averaging about 45 years of age. All had been diagnosed with either migraines or another type of intensely painful (and cyclically occurring) headache known as cluster headaches.
Before participating in the study, patients were asked to indicate their pain levels according to a standardized scale from 1 to 10. Pre-treatment pain scores averaged more than 8, Mandato said.
The participants all underwent a session of "image-guided therapy," in which a spaghetti-sized catheter was inserted through a nostril and into the nasal passage to deliver a dose of lidocaine to a nerve center known as the sphenopalatine ganglion. This was then repeated in the opposite nostril, according to the researchers.
Mandato stressed that no one in the study required sedation to undergo the procedure.
The target nerve bundle, explained Mandato, "resembles a complex highway crossing with many [nerve] signals and exits going in all directions." And, he said, the hope was that lidocaine would essentially short-circuit that bundle's headache-causing pathway.
The day after the procedure, average migraine pain levels had dropped from about 8 to just over 4. Pain scores rose only marginally a week after the procedure, and reached an average of just over 5 by the one month post-procedure mark, according to the study.
The procedure didn't help everyone, though. Seven of the patients (about 6 percent) failed to get any benefit from the treatment, the investigators found. However, 88 percent of those in the study reported needing less standard pain relief medication after the procedure.
The researchers acknowledged that this procedure is a temporary solution that would need to be repeated. Mandato said his team is continuing to monitor patients to see how well the nasal spray approach holds up six months out.
Dr. Richard Lipton, director of the Montefiore Headache Center in New York City, described the findings as "very dramatic."
"Unmet treatment needs in chronic migraine are huge, as is the overuse of medications," he noted. "When a body gets used to having a chronic headache suppressor, the patient can experience a rebound in the absence of that suppressor. So developing an effective treatment that can reduce the need for acute medicine would be very valuable," Lipton explained.
"These results sound very promising," Lipton added. "Of course, it remains to be seen if the demonstrated benefit already seen holds up over a longer period of time, and with a bigger group of patients."
Mandato and colleagues are scheduled to present their findings Sunday at the Society of Interventional Radiology annual meeting in Atlanta. Findings presented at meetings are generally viewed as preliminary until they've been published in a peer-reviewed journal.
The study received no funding from private industry.
More information
There's more on migraine treatment at the U.S. National Institute of Neurological Disorders and Stroke (http://www.ninds.nih.gov/disorders/migraine/migraine.htm#Is_there_any_treatment/ ).
SOURCES: Kenneth Mandato, M.D., vascular and interventional radiologist, Albany Medical Center, Albany, N.Y.; Richard B. Lipton, M.D., director, Montefiore Headache Center and professor of neurology, Albert Einstein College of Medicine, New York City; March 1, 2015, Society of Interventional Radiology meeting, Atlanta
by Alan Mozes

Ultrasound Treatment May Be Option for Plantar Fasciitis

Most patients found relief from foot pain in short study, but longer trials are needed, experts say
SUNDAY, March 1, 2015 (HealthDay News) -- An ultrasound technique is showing early promise as a quick and minimally invasive treatment for the common and painful foot condition known as plantar fasciitis.
The finding is based on a short-term study involving just 65 patients, the researchers noted.
"While the long-term outcome studies are in progress, the results we have seen to date are very promising," said study lead author Dr. Rahul Razdan, an interventional radiologist with Advanced Medical Imaging in Lincoln, Neb.
The American Orthopaedic Foot and Ankle Society describes plantar fasciitis as essentially an "overuse injury" resulting from inflammation of a band of tissue in the sole of the foot that links the heel bone to the base of the toes.
According to Razdan, standard treatment includes painkillers, cortisone shots, icing, heating, massage, silicone arch supports, and physical therapy centered on the benefits of controlled stretching. For some patients, invasive surgery is another option.
Dr. Raymond Monto is an orthopedic surgeon at Nantucket Cottage Hospital in Nantucket, Mass. He said that about 85 percent of patients will recover from plantar fasciitis with sufficient rest and standard treatment. However, the remaining 15 percent are so-called "problem patients" for whom typical treatments fail to provide relief.
"So when you're looking at chronic cases of disabling morning pain lasting three or four months or more, then absolutely it is warranted to explore new treatment options," said Monto, "because the treatments we currently have are just not that great for these kind of stubborn cases."
Razdan said the new ultrasound therapy is an entirely "novel approach" that uses ultrasonic energy to cut and remove damaged, pain-generating tissue while sparing healthy foot tissue.
In the study, Razdan's team tested the procedure on 65 patients who sought care at an interventional radiology clinic in 2013 and 2014.
All had chronic plantar fasciitis, and all had failed to respond to standard treatments.
During the ultrasound therapy, doctors guided a hollow needle tip into an area of "problem" tissue by means of ultrasound guidance. Once in position, the tip targeted a combination of high frequency/low amplitude sound to the damaged foot region. That broke up the pain-generating tissue, which was then extracted out of the foot.
In total, average treatment time was about a minute and a half, and sedation was not used.
According to the study, by two weeks after treatment, patients showed more than a 90 percent improvement (on average) in their foot disability assessments, compared with their pre-treatment status.
These improvements appeared to persist for at least six months out, with no notable complications, Razdan said.
"It's premature at six months to know if these kinds of early results can be sustained for longer periods of time," said Monto, who was not involved in the new research. "Still, it's a fascinating approach and certainly worth looking at further," he said.
However, Dr. Howard Luks, chief of sports medicine at Westchester Medical Center and New York Medical College in Valhalla, N.Y., said the idea isn't all that new. He said the idea of using ultrasound to address plantar fasciitis has been kicking around for the better part of a decade -- with mixed results.
"We do need more treatment options, and it would be nice to have a procedure to offer that's not invasive for patients who fail typical conservative measures," Luks said. "Surgery is never a great option when your foot's involved.
"But this idea," Luks added, "has been on the radar for a while. At a certain point it seemed to be coming into favor, and some offices even bought equipment to be able to offer it to patients. But then it fell out of favor, as some studies showed that it had moderate benefit, while others showed it had no benefit whatsoever.
"So I would say that there could potentially always be a renewed role for this, if it's clearly deemed to be efficacious," he said. "But it's certainly not new. And I would never bet the farm on any one study."
Razdan and his colleagues are slated to present their findings on Sunday at the annual meeting of the Society of Interventional Radiology in Atlanta. Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.
More information
There's more on plantar fasciitis at the The American Orthopaedic Foot and Ankle Society ( http://www.aofas.org/footcaremd/conditions/ailments-of-the-heel/Pages/Plantar-Fasciitis.aspx/ ).
SOURCES: Rahul Razdan, M.D., interventional radiologist, Advanced Medical Imaging, Lincoln, Neb.; Howard Luks, M.D., chief, sports medicine, Westchester Medical Center and New York Medical College, Valhalla, N.Y.; Raymond R. Monto, M.D., orthopedic surgeon, Nantucket Cottage Hospital, Nantucket, Mass; Society of Interventional Radiology meeting, Atlanta, Feb. 28 to March 5, 2015.
by Alan Mozes

Tips for Safe Snow Fun

Winter sports account for more than 343,000 injuries in U.S. a year, experts say
SATURDAY, Feb. 28, 2015 (HealthDay News) -- Winter sports are a great way to get exercise and fresh air, but they're not without risks.
In 2013, more than 343,000 people in the United States received medical treatment for winter sports injuries, according to the Consumer Product Safety Commission.
Skiing topped the treatment list, with 138,559 injuries. Snowboarding accounted for 95,348 accidents; sledding, more than 63,000; and ice skating, about 47,000.
"When it comes to winter sports, safety starts with knowing and practicing the rules," Dr. Michael Cheek, a sports medicine specialist and American Academy of Orthopaedic Surgeons spokesperson, said in an academy news release.
Many skiing and snowboarding injuries can be prevented by using proper equipment and getting appropriate training, he pointed out.
"Before hitting the slopes, inexperienced participants should consider taking a lesson [or several] from a qualified instructor to help prepare for the unexpected, like learning how to fall safely," Cheek said.
Common causes of sledding injuries include collisions at the end of sledding runs and sledding in improper positions.
General winter-sports safety advice includes going out with a partner and staying in sight of each other. Before heading outdoors, tell someone who isn't joining you about your plans and likely location.
The academy also recommends the following:
Check the weather before you leave, and pay attention to warnings about storms and severe temperature drops. Make adjustments for icy conditions, deep powder, wet snow and dangerous weather conditions. Always carry a cell phone in case of an emergency. Wear several layers of light, loose and water- and wind-resistant clothing, and appropriate protective gear such as goggles, helmet, gloves and padding. Check that all your equipment, such as ski and snowboard bindings, are in good working order. Be sure to warm up before your activity. Cold muscles, tendons and ligaments are at increased risk for injury.
More information
The U.S. Centers for Disease Control and Prevention offers winter health and safety tips (http://www.cdc.gov/features/winterweather/ ).
SOURCE: American Academy of Orthopaedic Surgeons, news release, Feb. 23, 2015
by Alan Mozes

ER Physician Raises Concerns About Powdered Caffeine

One teaspoon of substance equivalent to about 25 cups of coffee
FRIDAY, Feb. 27, 2015 (HealthDay News) -- The availability of both alcohol and caffeine in powdered form that can be added to food or drinks has sparked public concern, but one expert says the substances don't pose equal risks.
Several states, including Pennsylvania, have taken steps to preemptively ban the sale of powdered alcohol, but an emergency specialist warns that powdered caffeine is probably the greater health threat.
"Of the two, caffeine is the more concerning one for me," Dr. Glenn Geeting, an emergency physician at Penn State Hershey, said in a hospital news release.
One reason for his concern is that powdered caffeine can be easily purchased online. Another is that powdered caffeine is concentrated. A teaspoon of the substance contains roughly the same amount of caffeine as 25 cups of coffee. That's more than four times the amount that appears safe to consume in a day, according to the Penn State Hershey experts.
The main difference between powdered and liquid alcohol is its packaging. The powder may be more convenient to pack and carry, but it's not a concentrated form of alcohol. Critics warn however, young people may be tempted to snort it or use powdered alcohol to spike drinks.
The potential for abuse however doesn't seem any greater than the risks associated with liquid alcohol, according to Geeting.
"For those who are worried about powdered alcohol being smuggled into schools or theaters, it is likely to be harder to hide, more expensive than liquid alcohol and takes at least 30 seconds to dissolve," he said. "It would be really painful to snort and takes about half a cup of it to get an ounce of alcohol. It seems like it would be easier to just drink a shot."
Over the past year however, powdered caffeine has caused numerous overdoses nationwide that have resulted in hospitalizations, according to the news release. At least two people died after using the substance, said the Penn State Hershey experts.
"Like any drug, it creates a toxic syndrome, and it can create real problems," said Geeting. Signs of a caffeine overdose include:
Rapid or erratic heartbeats Agitation Vomiting Seizures
"While mortality is not very common with powdered caffeine, it is a possibility," Geeting noted. "I think it is worth using caution."
Complicating matters, powdered caffeine is considered a dietary supplement, which means it is not regulated by the U.S. Food and Drug Administration. The agency cautioned consumers against using the substance, to avoid a potential overdose. The FDA also advised parents to be aware of the danger this substance could pose to teens or young adults.
More information
The U.S. Food and Drug Administration provides more information on the dangers associated with powdered caffeine (http://www.fda.gov/Food/RecallsOutbreaksEmergencies/SafetyAlertsAdvisories/ucm405787.htm ).
SOURCE: Penn State Milton S. Hershey Medical Center, news release, Feb. 18, 2015
by Alan Mozes

Hepatitis C Infections in Hospitals Show Need for Tight Infection Control Practices

In both cases, there were breaches in safety rules, CDC reports
FRIDAY, Feb. 27, 2015 (HealthDay News) -- Two cases of hepatitis C infection that occurred during routine surgeries highlight the need for hospitals to tighten infection control to prevent more transmissions, officials said Friday.
In one case, two New Jersey patients (one of them had hepatitis C) received an injection of the anesthetic propofol from the same medication cart. In the other instance, two Wisconsin patients (one of them had hepatitis C) received kidneys that had been prepared for transplantation on the same machine, according to an article in the Feb. 27 issue of Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention.
The source of the infection in the Wisconsin case was not pinpointed, said Gwen Borlaug, coordinator of the HAI Prevention Program at the Wisconsin Division of Public Health, but "we identified breaches in infection control practices in the operating room that likely resulted in the transmission."
In the New Jersey case, the infection was traced to contaminated equipment that was taken from one operating room to another. Dr. Barbara Montana, medical director of the communicable disease service at the New Jersey Department of Health, said, "Fortunately, these infections can be prevented when health care providers follow basic infection prevention practices."
According to the CDC, 22 outbreaks of health-care-associated hepatitis infections occurred from 2008 through 2014. Most of the outbreaks occurred in outpatient care centers and long-term care facilities.
These outbreaks typically involved unsafe injection practices, such as using medication vials on multiple patients or reusing needles or syringes, Borlaug said. Other outbreaks have occurred as a result of contaminated items, such as blood sugar testing devices, she said.
"It is imperative to always practice sound infection control measures, such as cleaning and disinfecting used medical equipment and patient care items, and observing safe injection practices," Borlaug said.
Patients can also play a part in preventing these infections, Montana said.
"Patients should ask questions about infection prevention practices, such as whether health care providers are following good infection prevention practices, including hand washing and using a new needle/syringe for each patient and cleaning equipment between patients," she said.
Hepatitis C is a virus that attacks the liver. In its chronic form, it affects some 3.2 million Americans, according to the CDC. However, about 75 percent to 85 percent of those with chronic hepatitis C eventually develop acute disease, which can result in serious liver damage and liver cancer.
Hepatitis C is a leading cause of liver cancer and the need for liver transplantation, according to the agency.
Unlike its cousins hepatitis A and B, which can be prevented with a vaccine, there is no vaccine for hepatitis C. However, it can be treated.
Until widespread screening of the blood supply began in 1992 in the United States, there was no screening test for the virus. For that reason, the CDC recommends that anyone born between 1945 and 1965 get tested for hepatitis C.
Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, said these cases are likely only the tip of the iceberg and many more such infections occur in hospitals.
"These two cases are reminders of the small amount of hepatitis C virus that is necessary to cause infection and the importance of proper sterilization and handling of all dental and medical equipment at all times, especially amid a national epidemic of viral hepatitis with no vaccine for hepatitis C," he said.
More information
Visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/hepatitis/c/cfaq.htm ) for more on hepatitis C.
SOURCES: Barbara Montana, M.D., M.P.H., medical director, communicable disease service, New Jersey Department of Health; Gwen Borlaug, M.P.H., coordinator, HAI Prevention Program, Wisconsin Division of Public Health, Madison, Wisc.; Marc Siegel, M.D., professor, medicine, NYU Langone Medical Center, New York City; Feb. 27, 2015, Morbidity and Mortality Weekly Report
by Alan Mozes

Seasonal Flu Vaccine Even Less Effective Than Thought: CDC

And nasal version appears to provide no protection at all for young children
THURSDAY, Feb. 26, 2015 (HealthDay News) -- This year's flu vaccine is even more disappointing than previously reported, showing just 18 percent effectiveness against the dominant H3N2 strain of flu, U.S. health officials reported Thursday.
That's a drop from the 23 percent protection level estimated for the flu shot earlier in the season, said experts at the U.S. Centers for Disease Control and Prevention.
The situation for children was even worse. The CDC panel pegged the effectiveness of the injected vaccine for kids aged 2 to 8 to be just 15 percent.
And the nasal-spray version of the vaccine may not protect young children at all, health officials said.
"Studies can't confirm that the [nasal] vaccine has a benefit," said Dr. Joseph Bresee, chief of the Epidemiology and Prevention Branch at CDC's National Center for Immunization and Respiratory Diseases.
Why the poor performance?
"These low numbers, which are lower than we normally see, are because the flu viruses that are circulating have mutated to look very different than the vaccine strains," Bresee explained.
He added that the H3N2 flu strain that is currently circulating was not factored into this season's vaccine because decisions about which strains to target were made last February. As happens each year, choices about which strains to include are made months in advance so that manufacturers have time to make enough vaccine, Bresee explained.
In fact, this new strain of H3N2 was seen for the first time in March 2014 and didn't become dominant until September, Bresee noted. "That was much too late to make a new vaccine," he said.
"This is a very unusual circumstance where a new strain develops and becomes a dominant strain so quickly and after the vaccine had already been produced," he said.
On Thursday, the Word Health Organization made its recommendation for the makeup of next season's vaccine, Bresee said. Next week, the U.S. Food and Drug Administration will decide which strains will be included in next season's flu vaccine for the United States. Bresee said the FDA usually follows the WHO recommendations.
WHO recommended that this year's mutated H3N2 strain as well as updated versions of other strains be included in next season's vaccine, Bresee added.
Although this year's vaccine is only somewhat effective and the flu season has peaked, Bresee still recommends getting a flu shot.
"Year in and year out, flu vaccines are still the best way to protect yourself against flu," he said. "Most years, the vaccine is 50 to 70 percent effective. The vaccine doesn't protect everybody every time, but it's odds on the best way to protect yourself against flu."
Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, agreed that the vaccine is still the best protection against flu.
"Yes, it's still worth getting it though the season has already peaked," he said.
The CDC said that the flu season isn't over yet, and there is an increasing number of B viruses circulating, which are a better match to the vaccine and could bring final vaccine effectiveness numbers up.
This year's flu season has also hit children hard, the agency said, with 86 children dying from complications of flu by Feb. 7. For context, the CDC noted that in an average year, child deaths from flu vary from as few as 30 to as many as 170 or more.
The CDC currently recommends that everyone aged 6 months and older get vaccinated. Even if the flu shot isn't a perfect match to circulating strains, vaccination can still prevent some infections and reduce severe disease that can lead to hospitalization and death, the agency said.
Other ways to treat and prevent flu from spreading include early treatment with antiviral drugs such as Tamiflu and Relenza, and washing hands frequently and covering your mouth when coughing or sneezing.
Early treatment with antiviral drugs is especially important for children aged 2 and younger, along with adults aged 65 and older, the agency said. Others for whom these vaccines are essential are people with diabetes, heart disease or breathing problems, they added.
More information
Visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/flu/ ).
SOURCES: Joseph Bresee, M.D., chief, Epidemiology and Prevention Branch, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention; Marc Siegel, M.D., professor, medicine, NYU Langone Medical Center, New York City
by Alan Mozes

Hospital Design May Not Boost Patient Satisfaction, Research Suggests

Aesthetics aren't as important as care from doctors, nurses and staff, study notes
FRIDAY, Feb. 27, 2015 (HealthDay News) -- Hospital design has little effect on patient satisfaction, according to a new study.
Researchers analyzed surveys of more than 5,600 hospital patients in both newly renovated facilities and older facilities.
"Our team wanted to know how important aesthetics are to a patient's experience with care. So we looked at surveys from patients before and after a move. We then compared those results to satisfaction surveys from patients being cared for on similar units that had not undergone a move to a new facility," said study author Dr. Zishan Siddiqui. He is an assistant professor of medicine at Johns Hopkins University School of Medicine.
"We originally thought new and pleasing surroundings would improve patient satisfaction scores with physicians, nurses and overall care, but our study showed this is not the case," Siddiqui said in a Hopkins news release.
The study appears in the March issue of the Journal of Hospital Medicine.
Some hospital officials believe that improving their facilities to be more patient-focused will automatically improve patient satisfaction.
"Not so. Hospital leaders will have to stop blaming poor patient satisfaction scores on aging buildings and units," Siddiqui said.
"Although we did see significant improvement in facility-related satisfaction scores [in newer facilities], we did not see significant change in satisfaction related to care, or overall satisfaction, for that matter," he added.
More effective ways to improve patient satisfaction include training health care providers on personalized care, educating patients, and involving families in care decisions, the researchers said.
More information
The American College of Surgeons has more about doctor personalities and burnout (http://bulletin.facs.org/2013/06/personalities-and-burnout/ ).
SOURCE: Johns Hopkins Medicine, news release, Feb. 25, 2015
by Alan Mozes

Airport Screenings Miss Roughly Half of Sick Travelers: Study

Dishonesty among passengers about exposure to diseases biggest barrier to effective checks
FRIDAY, Feb. 27, 2015 (HealthDay News) -- Airport screenings for infectious diseases often miss 50 percent or more of sick travelers, mostly because people do not tell the truth about their exposure to illnesses, a new study suggests.
"Honest reporting can not only improve on-site detection, but is essential to enable authorities to follow up with travelers who may have been exposed but have not yet developed symptoms," wrote researcher and graduate student Katelyn Gostic, from the Lloyd-Smith Lab at University of California, Los Angeles.
Using a mathematical model, researchers from UCLA and the London School of Hygiene and Tropical Medicine analyzed airport screenings for six viruses: SARS coronavirus, Ebola virus, Middle East respiratory syndrome coronavirus (MERS-CoV), Marburg virus, influenza H1N1, and influenza H7N9.
They found one of the biggest barriers to successful health screenings at airports is a lack of honesty among passengers. This is a particular issue among travelers trying to avoid delays, they noted.
Gaining a better understanding of how infectious diseases progress could help ensure that passengers are asked the appropriate questions in screening surveys, the researchers said. For example, being exposed to a symptomatic Ebola patient is a risk factor for contracting the disease.
At best, 25 percent of people were honest about their exposure to the flu during the 2009 pandemic, the study published recently in the journal eLife showed. The researchers pointed out that some passengers might have even concealed their symptoms with medication.
The study's authors suggested that policymakers consider devoting more resources to arrival screening, which could reduce the number of missed cases.
"We found that for diseases with a long incubation period such as Marburg and Ebola, taking passengers' temperature to test for fever is particularly ineffective at the start of an epidemic but does pick up more cases as it stabilizes," Gostic said. In the early phase of disease epidemics, questionnaires are the most effective way to detect potential illnesses, she added.
Although screening for fevers upon arrival at a destination has been criticized for being ineffective, the study found this method could catch cases that were missed at departure.
When it comes to diseases such as swine flu, which take a shorter time to incubate, Gostic noted that fever screening is the most effective method throughout an epidemic.
Infrared noncontact thermometers do not pick up all fevers, usually only catching them 70 percent of the time, the researchers pointed out.
More information
The U.S. Centers for Disease Control and Prevention provides more information on health screenings at airports (http://www.cdc.gov/quarantine/contact-investigation.html ).
SOURCE: eLife, news release, Feb. 19, 2015
by Alan Mozes

Belief in Acupuncture Key to Effect on Back Pain, Study Suggests

Doctor says finding illustrates power of placebo effect
FRIDAY, Feb. 27, 2015 (HealthDay News) -- Acupuncture for back pain is more likely to help people who believe the treatment will work, new research suggests.
The study included 485 people who received acupuncture for back pain and completed questionnaires before they began treatment, at two and three months into treatment, and then again at six months after treatment.
Patients who had low expectations of acupuncture before they began the therapy gained less benefit than those who believed it would work, according to the researchers at the University of Southampton in England.
The investigators also found that patients who had a positive view of their back pain and felt in control of their condition had less back-related disability while undergoing acupuncture.
The findings, published in the March issue of the Clinical Journal of Pain, showed that "psychological factors were consistently associated with back-related disability," study author Dr. Felicity Bishop said in a university news release.
"When individual patients came to see their back pain more positively, they went on to experience less back-related disability," Bishop said.
"In particular," she explained, "they experienced less disability over the course of treatment when they came to see their back pain as more controllable, when they felt they had better understanding of their back pain, when they felt better able to cope with it, were less emotional about it, and when they felt their back pain was going to have less of an impact on their lives."
One arthritis doctor said the study findings illustrate an important point.
"This study emphasizes the influence of the placebo effect on pain. The process whereby the brain's processing of different emotions in relation to their treatment can influence outcome is a really important area for research," Dr. Stephen Simpson, director of research at Arthritis Research UK, said in the news release.
Arthritis Research UK funded the study.
More information
The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about back pain (http://www.niams.nih.gov/Health_Info/Back_Pain/default.asp ).
SOURCE: University of Southampton, news release, Feb. 12, 2015

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